1. Field of the Invention
This invention relates generally to orthopedic surgery, and more particularly to a cable system and method for closing the sternum after open heart surgery or a similar procedure.
2. Description of the Prior Art
For major thorasic surgery, such as open heart surgery, for example, the sternum is split from top to bottom to provide access to the organs in the thorasic cavity. Following the surgical procedure within the cavity, it is necessary to close and secure the sternum for healing. One procedure for doing this involves the making of pairs of holes in the sternum, one hole of the pair in each of the severed sides of the sternum. The hole pairs are in vertically spaced locations. A surgical wire is passed through the two holes of each pair, pulled tight to join the two halves of the sternum, and twisted together to stay tight.
Another procedure intended to better distribute the forces of the wires is disclosed in U.S. Pat. No. 4,512,346 to LeMole. In that disclosure, rods 16a and 16b located on the posterior surfaces of the sternum are used as anchors for surgical wires which are then pulled and twisted together to hold the sides of the sternum together for healing.
Another system disclosed in U.S. Pat. No. 4,583,541 to Barry uses wires through vertically spaced pairs of holes in the sides of the sternum and which match the vertically spaced pairs of holes in a strap located at the front of the sternum and through which the wires are received and then the wires are twisted together. The knots are received in a vertically extending groove in the strap.
Another system is disclosed in U.S. Pat. No. 4,730,615 to Sutherland et al, and employs a needle with an attendant metal spine portion 14 and a so-called head portion 12. The needle is the end of the spine portion and sharpened so that it can be pushed through intercostal tissue along the outer edge of the sternum, from outside toward the internal body cavity, and then pulled back out from behind the other half of the sternum. Then the locking serrations are pulled through the head portion 12 whereupon, when sufficient tension is applied, the locking of the appropriate serration with the tang 30 in the head portion will retain the fastener in place. Then the needle and excess metal spine portion are cut off.
Another approach is shown in U.S. Pat. No. 4,802,477 issued Feb. 7, 1989 to Gabbay.
Another approach is disclosed in U.S. Pat. No. 4,896,668 issued to Popoff et al. and wherein a vertically extending sternum plate is provided behind the sternum and receives a wire through it whose ends are secured in front of the sternum.
A U.S. Pat. No. 4,901,721 issued Feb. 20, 1990 to Hakki discloses a suturing device for cardio thorasic surgery
The Singerman et al. U.S. Pat. No. 3,311,110 issued Mar. 28, 1967 shows an earlier surgical needle and suture wire arrangement.
There is a system known as the Songer Cable System employed in orthopedic surgery. The cable typically comprises a bundle of forty-nine strands of wire. The cable is an eighteen gauge cable with a "top-hat" type of crimp thereon at the cable ends when fixed in site. The material used for the cable and crimp is 316 LVM stainless steel. One type uses a solid stainless steel cylindrical bar having two transverse holes drilled through it perpendicular to its longitudinal axis. The cable is threaded through one hole in the bar, and then around the device or structure to be secured, and then through the other hole in the bar. Tools are used for the functions of tensioning the cable and swaging crimps into place on the cable for abutting contact with the bar to maintain tension in the cable. U.S. Pat. No. 4,966,600 issued Oct. 30, 1990 to Songer et al. discloses and explains details of a Songer system.